As Hawaii continues to witness alarmingly high daily Covid-19 case counts driven by the delta variant, the battle emerging for our state is whether or not we can now protect our most vulnerable populations from death or serious illness. The most important thing now is not just how many people get vaccinated against Covid, but how many with weak immune systems get a booster shot as soon as possible.

Prior to the outbreak of the delta variant, things looked like they were starting to get under control both nationally and here in the islands. While resistance to Covid vaccines persisted on social media and occasionally erupted in a protest or two, for the most part, the effort to vaccinate the United States was extremely successful. When vaccine eligibility to all adults opened in the late spring, we saw infections and hospitalizations drop significantly.

It is during such times of calm that one must remain alert, for if history teaches us anything, when people are touting “peace and safety,” destruction has a way of surprising us like a flood. Prophets are always sent to preach a warning before disaster comes, but prophets are often dismissed, resulting in an avoidable disaster. Government is often too slow to respond to or pick up on emerging trends, and situations can change rapidly before corrective actions can be taken.

As soon as the vaccines started rolling out to the full adult population, some independent experts started talking about the possibility of needing a booster shot of the Covid vaccine to protect against future infection. The FDA and CDC, as well as President Joe Biden, however, pushed back hard against suggestions of a booster shot, but added a careful caveat that their studies all said that boosters were not needed “at this time.”

And then the “at this time” assurance got a gut check as the delta strain exploded across the United States.

A CDC report entitled, “Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings” found that “in a Barnstable County, Massachusetts, town, 469 COVID-19 cases were identified among Massachusetts residents who had traveled to the town during July 3–17; 346 (74%) occurred in fully vaccinated persons. Testing identified the Delta variant in 90% of specimens from 133 patients.”

For those not familiar with the science, the Covid vaccine’s effectiveness can be hampered by a number of things, not the least of which includes the viral exposure time and concentration one receives, as well as the amount of antibodies one’s immune system is able to produce. This is why Covid case numbers do matter, because if many people are sick, the risk of being exposed to a higher viral load in public increases.

As time passes from an initial vaccination, the level of antibodies also declines, and that has serious implications for the possibility of getting seriously sick with Covid. Anyone who tries to tell you “Covid immunity is for life” is gaslighting you. It just doesn’t work that way.

Today, most of the United States is a hot spot for the delta strain, which constitutes most of the new cases. Across the country, and here in Hawaii, hospitalizations are rising and there is now the danger of the health care system being overloaded by coronavirus cases.

Not surprisingly, last week the CDC backpedaled on Covid booster shots and ruled that immunocompromised people are now eligible for three mRNA shots, so long as they self-attest to one or more of several conditions. Among the categories are those who received active cancer treatment for tumors or cancers of the blood, received an organ transplant and are taking medicine to suppress the immune system, received a stem cell transplant within the last two years or are taking medicine to suppress the immune system.

Other criteria include moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome), advanced or untreated HIV infection or active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.

Take this change in policy as a red flag that the war on Covid is about to take a drastic turn. I am not convinced that nationally or locally we will be able to contain the proliferation of the delta infections. This means that those who have weak immune systems need to take urgent action to protect themselves because one’s government and neighbors alike cannot be counted upon to act fast enough to buffer them against the spread of the virus.

Forget about vaccine hesitancy among the general population. We need to think about booster initiatives among the immunocompromised, which may be as many as 3% or more of the population. If you are reading this and you qualify with any of the conditions for which a third mRNA shot has been approved, don’t wait for someone to prompt you to get the booster, just go and get it. No prescription is needed for the booster shot, as you merely have to self-attest at the vaccination site that you qualify for the shot.

To find out where a booster shot is available, you can SMS text your ZIP code to 438829, or call 1-800-232-0233 or visit Vaccines.gov for more information.

We are well past the point of lockdowns, shutdowns, and begging anti-vaccine resisters to get vaccinated here in Hawaii. The delta variant is spreading and our leaders are not going to save us. Take initiative. Save yourselves. We’ll argue about the politics of this crisis later when we survive to write the history books.